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Chalazia Development in Multiple Myeloma: A New Complication Associated with Bortezomib Therapy
Charles Yun1, Nikhil Mukhi1, Valerie Kremer1
1Division of Hematology/Oncology , New York, NY, USA.
Abstract:
Multiple myeloma (MM) is a neoplasm of plasma cells within the bone marrow. A major impact on improving survival in MM has been the use of the boronic acid-derived proteasome inhibitor bortezomib, a first-in-class selective inhibitor of the 26S proteasome. Ocular side effects of bortezomib are rare. In this report, we present 2 patients with active MM in whom persistent chalazia became a therapy-interfering complication of treatment with bortezomib. Both patients had relapsed ISS III B kappa light chain myeloma, and they were responding to treatment with bortezomib until chalazia - which caused intolerable discomfort - started. In both patients discontinuation of bortezomib was necessary for chalazia to heal, and restarting of bortezomib was associated with relapse of chalazia.
Insights
Persistent chalazia, a rare ocular side effect, can interfere with bortezomib treatment for multiple myeloma (MM). Discontinuation of bortezomib was necessary for healing, with recurrence upon re-initiation.
Area of Science:
- Oncology
- Ophthalmology
- Pharmacology
Background:
- Multiple myeloma (MM) is a bone marrow cancer.
- Bortezomib, a proteasome inhibitor, has improved MM survival.
- Ocular side effects of bortezomib are uncommon.
Observation:
- Two patients with relapsed MM experienced persistent chalazia during bortezomib therapy.
- The chalazia caused significant discomfort, interfering with treatment.
- Chalazia resolved upon bortezomib discontinuation in both cases.
Findings:
- Bortezomib treatment cessation led to chalazia healing.
- Re-initiation of bortezomib therapy resulted in chalazia recurrence.
- This suggests a direct link between bortezomib and chalazia development.
Implications:
- Ocular side effects like chalazia should be monitored in MM patients on bortezomib.
- Management of chalazia may require bortezomib dose adjustment or discontinuation.
- Further research is needed to understand the mechanism of bortezomib-induced chalazia.
